A comparison of the fixed combination of latanoprost and timolol with the unfixed combination of brimonidine and timolol in patients with elevated intraocular pressure. A six month, evaluator masked, multicentre study in Europe

García–Sánchez, J.; Jf, Rouland; Spiegel, D.; Pajic, Bojan; Cunliffe, I A; Traverso, C. E.; Landry, John

doi:10.1136/bjo.2003.029330

Cited by 25 publications

(16 citation statements)

References 36 publications

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“…16 mmHg) on mono-or dual therapy had lower diurnal IOP with FCLT (16.9 mmHg) than concomitant brimonidine and timolol (18.2 mmHg), P , 0.001, at 6 months, 156 also supported by a cross-over study with a 1-month timolol run-in period. 154 Data from 3 Phase III clinical studies 199,200 have shown that the fixed combination of bimatoprost 0.03%/timolol 0.5% (FCBT) ophthalmic solution (Ganfort ® ; Allergan inc., Irvine, CA) was significantly more effective in lowering IOP, with a higher percentage achieving mean reduction in diurnal IOP of .20% or a target pressure of ,18 mmHg, than timolol or bimatoprost monotherapy.…”

Section: Pga/timolol Fixed Combinationsmentioning

confidence: 60%

“…Head-to-head trials post-dated the study hence studies comparing the medication in question and timolol 71-73, 81,116,119,147,148 or betaxolol 149 were included. In contrast, head-to-head trials, 43,52,53,59,70,76,77,83,[150][151][152][153][154][155][156][157] only were analyzed for the second meta-analysis. 146 The pooled summary estimate significantly favored latanoprost (weighted mean difference (WMD) = 1.10, 95% CI 0.57 to 1.63) over brimonidine.…”

Section: Vs Brimonidinementioning

confidence: 99%

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Clinical utility and differential effects of prostaglandin analogs in the management of raised intraocular pressure and ocular hypertension

Lee

McCluskey

2010

OPTH

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Prostaglandin analogs (PGA) are powerful topical ocular hypotensive agents available for the treatment of elevated intraocular pressure (IOP). Latanoprost 0.005% and travoprost 0.004% are prodrugs and analogs of prostaglandin F2α. Bimatoprost 0.03% is regarded as a prostamide, and debate continues as to whether it is a prodrug. The free acids of all 3 PGAs reduce IOP by enhancing uveoscleral and trabecular outflow via direct effects on ciliary muscle relaxation and remodeling of extracellular matrix. The vast majority of clinical trials demonstrate IOP-lowering superiority of latanoprost, bimatoprost and travoprost compared with timolol 0.5%, brimonidine 0.2%, or dorzolamide 2% monotherapy. Bimatoprost appears to be more efficacious in IOPlowering compared with latanoprost, with weighted mean difference in IOP reduction documented in one meta-analysis of 2.59% to 5.60% from 1-to 6-months study duration. PGAs reduce IOP further when used as adjunctive therapy. Fixed combinations of latanoprost, bimatoprost or travoprost formulated with timolol 0.5% and administered once daily are superior to monotherapy of its constituent parts. PGA have near absence of systemic side effects, although do have other commonly encountered ocular adverse effects. The adverse effects of PGA, and also those found more frequently with bimatoprost use include ocular hyperemia, eyelash growth, and peri-ocular pigmentary changes. Iris pigmentary change is unique to PGA treatment. Once daily administration and near absence of systemic side effects enhances tolerance and compliance. PGAs are often prescribed as first-line treatment for ocular hypertension and open-angle glaucoma.

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Section: Pga/timolol Fixed Combinationsmentioning

confidence: 60%

Section: Vs Brimonidinementioning

confidence: 99%

Clinical utility and differential effects of prostaglandin analogs in the management of raised intraocular pressure and ocular hypertension

Lee

McCluskey

2010

OPTH

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“…17,28 In the present research, both combination therapies showed a mean IOP-reducing effect from baseline of about 35%. As far as FC latanoprost/timolol is concerned, this level of reduction is toward the high end of the range of decreases found in previous studies 31,[33][34][35][36][37][38][39] with morning dosing and no timolol run-in (range, 31.5-36.0%). With regard to the FC 40 use of systemic b-blockers was not an exclusion criterion in this study if the subject and dosage were stable for 3 months before screening and if the dosage was not expected to change during the study.…”

Section: Fixed-combination Ocular Hypotensives S Miglior Et Almentioning

confidence: 77%

Efficacy and safety of fixed combinations of latanoprost/timolol and dorzolamide/timolol in open-angle glaucoma or ocular hypertension

Miglior

Grunden

Kwok

2009

Eye

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Aims To compare intraocular pressure (IOP) reductions with fixed-combination (FC) latanoprost/timolol once daily in the evening vs FC dorzolamide/timolol twice daily. Methods This evaluator-masked, multicentre, controlled clinical trial randomized subjects with primary open-angle glaucoma or ocular hypertension with IOP insufficiently responsive to b-blocker therapy (screening IOP421 and o37 mm Hg) to FC latanoprost-timolol (N ¼ 135) or FC dorzolamide/timolol (N ¼ 135). At screening, baseline, and after 4 and 12 weeks of therapy, IOP was measured three times at 0800, 1200, and 1600 hours. Adverse events were recorded at each visit. The primary efficacy end point was whether either FC could be shown to be inferior to the other with respect to change in mean daytime IOP from baseline to week 12. Results Mean daytime IOP levels were similar at baseline. Mean reductions in daytime IOP from baseline to week 12 were À9.7 mm Hg for FC latanoprost-timolol and À9.5 mm Hg for FC dorzolamide/timolol. The difference between FC latanoprost/ timolol-FC dorzolamide-timolol was À0.2 mm Hg (95% confidence interval (CI), À0.8 to -0.4 mm Hg). The upper bound of the 95% CI was o1.5 mm Hg, indicating that neither FC is inferior to the other. However, a significantly greater percentage of subjects treated with FC latanoprost/timolol achieved IOP levels p16 and p15 mm Hg (Pp0.01). Both treatments were well tolerated. Conclusions When b-blocker therapy is inadequate, either FC may achieve the desired IOP level, but FC latanoprost/timolol more oftenly achieves a pressure of p16 mm Hg. Both FCs were well tolerated.

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“…A recent 6-month study compared the fixed combination of latanoprost– timolol with concomitant use of brimonidine and timolol in 325 patients. At the 6 month visit, mean IOP was 16.9(standard deviation [SD] 2.8)mm Hg in the fixed combination group and 18.2(SD 3.1) mm Hg in the brimonidine–timolol group (p<0.001) (Garcia-Sanchez et al 2004). …”

Section: Fixed Combinationsmentioning

confidence: 99%

The management of glaucoma and intraocular hypertension: current approaches and recent advances

Noecker¹

2006

Therapeutics and Clinical Risk Management

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Abstract:In the last decade, numerous novel ocular hypotensive agents have been introduced for the control of intraocular pressure (IOP). Clinicians now have more options than ever in the selection of medical therapy for the treatment of glaucoma and ocular hypertension. When selecting an ocular hypotensive medication for their patients, clinicians should consider not only the IOP-lowering efficacy of an agent, but also the ability of the drug to allow patients to achieve target levels of IOP that are low enough to stop the progression of glaucomatous damage. Other considerations should include how well the drug controls diurnal IOP, the likelihood of serious adverse events, the versatility of the medication for use as an adjunctive agent, as well as other potential attributes (ie, neuroprotection).

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A comparison of the fixed combination of latanoprost and timolol with the unfixed combination of brimonidine and timolol in patients with elevated intraocular pressure. A six month, evaluator masked, multicentre study in Europe

Cited by 25 publications

References 36 publications

Clinical utility and differential effects of prostaglandin analogs in the management of raised intraocular pressure and ocular hypertension

Clinical utility and differential effects of prostaglandin analogs in the management of raised intraocular pressure and ocular hypertension

Efficacy and safety of fixed combinations of latanoprost/timolol and dorzolamide/timolol in open-angle glaucoma or ocular hypertension

The management of glaucoma and intraocular hypertension: current approaches and recent advances

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